Ocular microcirculation changes, measured with laser speckle flowgraphy and optical coherence tomography angiography, in branch retinal vein occlusion with macular edema treated by ranibizumab

Int Ophthalmol. 2021 Jan;41(1):151-162. doi: 10.1007/s10792-020-01562-7. Epub 2020 Sep 7.

Abstract

Purpose: This study searched for early predictive vascular biomarkers for visual outcomes in eyes with macular edema caused by branch retinal vein occlusion (BRVOME).

Methods: Twenty-four eyes of 24 subjects with BRVOME were treated with the intravitreal injection of ranibizumab (IVR) for at least 6 months. We measured mean blur rate (MBR) in the optic nerve head (ONH) and vessel density (VD) in the macula with laser speckle flowgraphy and optical coherence tomography angiography, respectively.

Results: Six-month post-IVR best-corrected visual acuity (BCVA) was correlated positively with age, pre-IVR BCVA, 1-month post-IVR BCVA, 3-month post-IVR BCVA and pre-IVR systolic blood pressure (P < 0.001, P < 0.001, P < 0.001, P < 0.001 and P = 0.02, respectively) and negatively with pre-IVR overall MBR, 1-month post-IVR overall MBR, 6-month post-IVR overall MBR, 3-month post-IVR deep retinal capillary plexus (DCP) VD and 6-month post-IVR DCP VD (P = 0.03, P = 0.03, P = 0.02, P = 0.01 and P = 0.005, respectively). Furthermore, a multiple regression analysis showed that pre-IVR overall MBR (β = - 0.67, P = 0.009) was among independent prognostic factors predicting 6-month post-IVR BCVA. Six-month post-IVR DCP VD was also correlated with overall MBR at all time points.

Conclusion: ONH blood flow may be a pre-IVR biomarker of both visual outcomes and post-IVR deep macular microcirculation in eyes with BRVOME.

Keywords: Foveal avascular zone; Macular capillary plexus; Mean blur rate; Ocular blood flow; Optical coherence tomography angiography.

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Fluorescein Angiography
  • Humans
  • Intravitreal Injections
  • Lasers
  • Macular Edema* / diagnosis
  • Macular Edema* / drug therapy
  • Macular Edema* / etiology
  • Microcirculation
  • Ranibizumab / therapeutic use
  • Retinal Vein Occlusion* / complications
  • Retinal Vein Occlusion* / diagnosis
  • Retinal Vein Occlusion* / drug therapy
  • Tomography, Optical Coherence
  • Visual Acuity

Substances

  • Angiogenesis Inhibitors
  • Ranibizumab